SUMMARY

• Over 6 years of extensive experience as a Sr. Business Analyst in Healthcare Domain with expertise in Software development methodologies like Agile, waterfall and Rational unified Process (RUP) methodologies
• Designed and reviewed various documents including the System Requirement Specifications (SRS), Business requirements document (BRD), Use Cases, Functional Specifications (FSD), Systems Design Specification (SDS), Requirement Traceability Matrix (RTM) and testing documents
• In depth knowledge of UML in visualizing and documenting the artifacts using Use Cases diagrams, Class diagrams, Sequence diagrams, and Collaboration diagrams in Rational Rose and MS-Visio
• Experienced in facilitating Joint Application Development (JAD), Rapid Application Development (RAD) and Joint Requirement Planning (JRP) sessions, interviews, workshops and requirement elicitation sessions with end-users, clients, stakeholders and development team
• Knowledge of Claims Processing and HIPAA regulations
• Experience with writing SQL queries.
• Extensive Knowledge of Medicare, Medicaid, procedural and diagnostic codes
• Knowledge of EDI and HIPAA Testing Privacy with multiple transactions exposure such as 837, 834, 835, 277, 270, 271 and D.0 NCPDP
• Experience in Conversion of HIPAA X12 4010 transactions to X12 5010 transactions and knowledge of ICD 9 - ICD 10 conversions
• Working Knowledge of Client-server Architecture and Application Servers
• Facilitated project meetings, reviews, walkthroughs, and customer interviews to gather requirements and relevant information for Business analysis
• Generated Requirement Traceability Matrices to ensure that all the requirements were met in each phase of the Software Development Life Cycle
• Experienced in handling Change Management, writing Test Plans and executing Test Cases
• Experienced as BA/QA analyst in Defect Tracking and extensively involved in User Acceptance Testing (UAT)
• Exceptional Problem Solving and Sound Decision Making capabilities, along with the ability to resolve difficult situations
• Creative and aggressive self-starter with integrative thinking skills and capable of communicating creative ideas through Graphical Modeling

TECHNICAL SKILLS:

• Methodologies: RUP, Waterfall, Agile, Scrum, OOAD
• Microsoft Tools : MS Word, MS Excel, MS PowerPoint, MS Project, MS Visio
• Databases : MS Access, SQL Server
• Platforms: Windows7/XP/VISTA, MS DOS, Mac OS, LINUX
• Modeling Tools: MS Visio, Rational Rose
• Testing Tools: HP Quality Center, Load Runner, Bugzilla
• Version Control Tools: MS SharePoint, Concurrent Version System (CVS)

PROFESSIONAL EXPERIENCE

Confidential,NJ June11 ’–Till Present

Sr. Business Analyst

I was involved in developing fully automated, real-time claims processing system for complete, on-line medication of medical, dental, vision, and disability claims and encounters as per HIPAA guidelines.

Responsibilities:

• Extensively involved in gathering requirements from clients and created Business Requirement Document (BRD) and facilitated in creating System Requirement Specifications (SRS) Document.
• Acted as a Liaison between IT Team and Business Client, analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams, State Chart Diagrams using Rational Rose according to UML methodology
• Applied RUP methodology with its various workflows, artifacts and activities throughout the software development life cycle from Inception to Transition phase
• Facilitated JAD sessions with different stakeholders on their objectives and closely worked with the developers and testers throughout the project
• Identified the business flow and determined whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA
• Analyzed the As Is system and developed the To Be system concept, thus performed GAP analysis. Worked on EDI transactions: 270, 271, 835, and 837 to identify key data set elements for designated record set
• Maintained proper communication with the developers ensuring that the modifications and requirements were addressed and monitored
• Involved in compatibility testing with other software programs, hardware, Operating systems and network environments
• Assisted the team lead in developing Requirements Traceability Matrix (RTM) to trace the relationship between business and functional requirements to test cases. Prepared and executed different Test Cases and Test Scripts
• Involved in conducting Functionality testing, Integration testing, Regression testing and User Acceptance testing (UAT)
• Provided analysis and insight to QA Team in defects and bug tracking.

Confidential,
Sr. Business Analyst

Responsibilities:

• Performed Gap analysis for the modules in production, conducted feasibility studies and performed impact analysis for proposed enhancements
• Gathered Business Requirements, interacted with the stakeholders, developers, Project Manager and SME’s and facilitated JAD sessions to formulate Business Processes.
• Conducted interviews with various business users to collect requirement and business

process information and documented them using MS Visio.

• Worked with project management to analyze change requests to determine what is being

requested and did the required.

• Acted as the primary liaison between the business stakeholders and technical teams to make communication and development efforts more effective
• Developed functional specifications for the existing WEDI software enhancements (enhanced security &privacy rules, transaction standards, code sets, identifiers) ensuring the system is HIPPA complaint
• Involved in daily scrum meetings and implemented Agile methodology
• Created Business Requirements Documents (BRD) and Functional Requirements Specifications (FRS) documents.

Environment: Windows NT/2000, MS SQL Server, Rational Unified Process (RUP), UML, Rational Rose & Requisite Pro, Mercury Quality Center, Clear Quest, MS Office Tools, MS Outlook.

Confidential,VA Nov ’09 – Nov ‘10

Sr. Business Analyst
I Worked with a web based application that was taking care ofOnline Account Servicesthat included Billing Application, Checking the bill history, Changing customer profile, Ordering auto insurance ID cards and Modifying the load provider details.

Responsibilities:

• Gathered business requirements by driving user-group meetings and working with various global, cross-functional and virtual teams
• Interacted and arranged meetings with Business and End users to gather business requirements for changes triggered by Government regulations and HIPAA, Business needs and Process improvement.
• Prepared User Requirements Document (URD), Business Requirements Document (BRD) and Functional Requirements Document (FRD).
• Worked closely with project manager in setting realistic project expectations and in evaluating the impact of the changes of the organization and plan accordingly
• Received the Client and Business users appreciation for the implementation of Prescriber NPI update and E-prescribing changes
• Developed Flowchart and process diagram using Microsoft Visio
• Performed Unit Testing and User Acceptance Testing and documented detailed defects.
• Developed Test Cases to validate the requirements and documented the Traceability Matrix for Test Cases and Requirements
• Followed the RUP based methodology to create Use Case, Activity/ State Chart, Sequence, and Collaboration Diagrams.
• Worked on Required Traceability Matrix (RTM) for traceability of requirements.
• Conducted GAP analysis by understanding the AS-IS system and the TO-BE system requirements with the support from SME’s
• Ensured the accuracy and consistency of the data during the data loading process
• Was in regular contact with Business partners on the status of issues, action plans and timeframe for resolution throughout the development cycle

Environment: Windows, MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS Access, MS Project, Rational Rose, Community Manager, BPML, SQL, Clear Case, Agile

Confidential,CT Dec ‘07 – Oct ‘09

The project aimed at assisting the Executive Team to analyze the performance of various insurance product lines like life, health, annuity, dental, long term disability, etc for both individual and groups based on key performance Metrics. Timely reports were generated based on the captured statistics and their performance was tracked in an efficient manner.

Responsibilities:

• Documented business requirements by working with Subject Matter Experts (SME) and communicated these requirements to the development team for the design and implementation of business solutions
• Carried out detailed and comprehensive business analysis with Rational Unified Process (RUP) methodology
• Coordinated brainstorming and JAD sessions with stakeholders and end-users for requirement analysis and documented the same
• Created Use Case models, Analysis models, Design Models, Implementation Models, Activity diagrams based on UML methodology using MS Visio
• Prepared and Analyzed AS IS and TO BE work flow scenario and performed GAP Analysis
• Created Mock-up forms in for better visualization and understanding of the software solution and regularly worked with the CMA (Change Management Application) and CDA (content Display Management) teams
• Facilitated in developing the Test scenarios, Test plan, Test conditions and Test cases to be used in testing based on business requirements and technical specifications
• Successfully implemented Change Request and defect tracking.
• Coordinate with the plan owners to update the project plans with any impact due to change request. Verify if the contingency plan will absorb any delay in project due to change request.
• Facilitated UAT and Test strategies with the developers and testers and performed manual front-end testing to check all the functionalities incorporated with the different modules

Environment: RUP, Mercury Quality Center, MS office Suite, SharePoint, MS Project, MS Visio, SQL

Confidential,CA June ‘07 – Nov ‘07

Business Analyst
I worked as an implementation analyst on EMR implementations in various clinics and hospitals. In the Legacy application, the clinics/hospitals received their patient reports from the labs via fax or printer installed at their location. In current system, they order electronically through the vendor EMR installed in their office, Print out the E-requisition instead of filling it manually and send it with the specimen. Also they receive their reports electronically via the vendor EMR.

Responsibilities:

• Actively interacted with the client and the sales team to gather client requirements regarding the patient Electronic Medical Reports.
• Analyzed Business Requirements, developing, tracking and enhancing them into functional requirements.
• Collected and documented business processes as well as business rules.
• Developed the Specification Requirements Document (SRS) based on the vendor interaction and user requirements.
• Interacted with the third party vendors to collect details and quotes regarding the Vendor EMR.
• Coordinated closely with the diagnostic lab and sales team for approvals.
• Developed Use Cases for the main modules and describe the requirements to the developers.
• Conducted JAD sessions with the entire team.
• Worked closely with the development team to communicate client requirements
• Worked closely with the Project Manager in handling the scope creep and analyzing its effects
• Provided key input in working with users in defining project and system requirements.
• Communicate any final adjustments required based on user feedback.
• Held regular status meetings on behalf of the Project Manager to keep track of the status.
• Created and maintained the Requirements Traceability Matrix to keep track of each requirement.
• Designed and developed Use Cases, Activity Diagrams, and Sequence Diagrams, using MS VISIO.
• Presented reports and analysis to help guide the management.

Environment: Microsoft Office (Excel Word, PowerPoint, Project), Macros, Rational Requisite Pro, MS Visio.

Confidential,India Jan ‘06 - May ‘07

Business Analyst
The Project was to redefine and rebuild a financial application to make it easier for workers to complete expense reports for reimbursements. This included gathering and documenting the user requirements, analyzing the existing system, performing a gap analysis and coming up with the target system.

Responsibilities:

• Interacted with client to assess needs, identify key challenges, and define project Scope and deliverables
• Analyzed software requirements specification (SRS), prepared functional specification document (FSD), and designed documents as per standards
• Conducted group JAD sessions with business units and stakeholders to define project scope and deliverables
• Extensively used the UML methodology to create various use case diagrams.
• Responsible for creating artifacts for Rational Unified Process (RUP) - use cases, system architecture document, supplemental requirements document, architecture diagrams; verifying technical production infrastructure; designing and executing performance tests; and documentation
• Review architectural templates, process flow diagrams, cross walk documentation for the current systems
• Assisted Quality Assurance (QA) team in writing test plans, defining test cases, test scenario and data sets
• Developed Process flow charts which helped in better understanding of the system
• Performed integration testing, product testing, User Acceptance Testing (UAT) and data driven testing
• Facilitated different development and testing groups to ensure smooth flow of information

Environment: Rational Rose, Rational Requisite Pro, MS Project, MS Access, MS Excel, MS PowerPoint, WINDOWS NT, WINDOWS 2000.